Abstract 885P
Background
The aim of this prospective study is to identify the biomarkers associated with the effects of induction chemotherapy (iCHT) in terms of the favorable/weaker response to the treatment in locally advanced head and neck squamous cells carcinomas (LA-HNSCC) as well as to correlate the metabolic and clinical response to iCHT with the patients' overal survival.
Methods
The studied group consisted of 53 LA-HNSCC patients treated with iCHT. The treatment tolerance was measured by the Common Terminology Criteria for Adverse Events (CTCAE). The response to the treatment was evaluated by the clinical, fiberoptic and radiological examinations made before and after iCHT (the TNM Classification of Malignant Tumors was used for classifying the extent of cancer spread). Proton nuclear magnetic resonance (1H NMR) serum spectra of the samples collected before and after iCHT were acquired with a 400 MHz spectrometer and analyzed using the multivariate and univariate statistical methods. Treatment failure occured in 24 patients with median follow-up (FU) 24.6 months (since the ent of post-iCHT radiotherapy). The median FU for the remaining 29 patients was 88 months.
Results
The molecular response to iCHT involves an increase of the serum lipids which is accompanied by the simultaneous decrease of alanine, glucose and N-acetyl-glycoprotein (NAG). Furthermore, in males, the iCHT induced changes in the lipid signals and NAG significantly correlate with the regression of the primary tumor. The regression of the primary tumor after iCHT showed no correlation with the treatment failure and FU. Male patients with treatment failure showed significantly lower serum lipids (both, pre- and post-iCHT) compared to those with favorable outcome.
Conclusions
The NMR-based metabolomic study of the serum spectra revealed that iCHT induces the marked changes in the LA-HNSCC patients’ metabolic profiles and makes it possible to stratify the patients according to their response to iCHT as well as to possibly predict the treatment failure. These effects are sex dependent. Further studies on a larger scale accounting for sex and the clinical and metabolic factors are warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
National Science Centre of Poland (Grant 2015/17/B/NZ5/01387).
Disclosure
All authors have declared no conflicts of interest.